NPI | 1083477103 |
---|---|
Entity Type | Organization |
Authorized Contact | MIRACLE A DOUGLAS Owner/Provider 470-710-9221 |
Organization Subpart ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics |
Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
224Z00000X Occupational Therapy Assistant | |
224ZF0002X Occupational Therapy Assistant Feeding, Eating & Swallowing | |
225200000X Physical Therapy Assistant | |
225A00000X Music Therapist | |
225XF0002X Occupational Therapist Feeding, Eating & Swallowing | |
225XP0200X Occupational Therapist Pediatrics | |
235Z00000X Speech-Language Pathologist | |
Enumeration Date | 2024-02-01 |
Last Update Date | 2024-02-01 |